NPI | 1073868519 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024172480) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.0037515) |
363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306145) | |
363LA2200X Nurse Practitioner, Adult Health (Licence: SC APN.29631) | |
Enumeration Date | 2012-07-20 |
Last Update Date | 2025-02-13 |